title: Interpregnancy weight change and risk for adverse perinatal outcome.
abstract: OBJECTIVE
  To examine the association between interpregnancy weight change and the risk for adverse maternal and neonatal outcomes.
  
  
  METHODS
  All live-born singleton births delivered at 21-42 weeks of gestation in women who had their first two consecutive births between 2009 and 2011 in Flanders (the northern part of Belgium) and who were included in the Study Center for Perinatal Epidemiology database (N=7,897) were included. Interpregnancy weight change was calculated as the difference between the prepregnancy body mass index (BMI) of the first pregnancy and the prepregnancy BMI of the second pregnancy. Multivariate logistic regression analysis to predict gestational diabetes mellitus, pregnancy-induced hypertension, cesarean delivery, macrosomia (4,000 g or greater), low birth weight (less than 2,500 g), and congenital malformations were performed.
  
  
  RESULTS
  The adjusted odds ratio (OR) for gestational diabetes mellitus was 2.25 (95% confidence interval [CI] 1.33-3.78; P=.002) for interpregnancy weight retention of 2 or more BMI units, and the adjusted OR for pregnancy-induced hypertension was 3.76 (95% CI 2.16-6.57; P<.001) with an increase of 3 or more BMI units between pregnancies, but these associations were only present in underweight and normal-weight women. In overweight and obese women, the adjusted OR was 2.04 (95% CI 1.41-2.95; P<.001) for cesarean delivery for an interpregnancy weight retention of 2 or more BMI units. In underweight and normal-weight women, the risk for macrosomia was halved if women lost more than 1 BMI unit between pregnancies, but at the same time, the risk for low birth weight doubled.
  
  
  CONCLUSIONS
  We show that weight retention between the first and second pregnancy is associated with an increased risk for perinatal complications, even in underweight and normal-weight women. Stabilizing interpregnancy weight appears an important target for reducing adverse perinatal outcomes in a second pregnancy.
  
  
  METHODS
  II.
authors.affiliation: KHLim, Limburg Catholic University College, PHL University College, Department of Healthcare Research, Hasselt, the Departments of Psychology and Development and Regeneration, KU Leuven, the Center of Human Genetics, University Hospitals Leuven, and the Department of Obstetrics & Gynaecology-Division of Mother & Child, University Hospitals, Leuven, and the Department of Welfare, Public Health and Family, Flemish Government, and the Flemish Study Center for Perinatal Epidemiology, Brussels, Belgium; and the Department of Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Annick
authors.initials: A
authors.lastname: Bogaerts
authors.forename: Bea R H
authors.initials: BRH
authors.lastname: Van den Bergh
authors.forename: Lieveke
authors.initials: L
authors.lastname: Ameye
authors.forename: Ingrid
authors.initials: I
authors.lastname: Witters
authors.forename: Evelyne
authors.initials: E
authors.lastname: Martens
authors.forename: Dirk
authors.initials: D
authors.lastname: Timmerman
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
mesh_terms: D000328:Adult; D001530:Belgium; D001719:Birth Certificates; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000209:etiology; D007230:Infant, Low Birth Weight; D008423:Maternal Age; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D015430:Weight Gain; D015431:Weight Loss; D055815:Young Adult